基于社区的状态中性多层次干预措施，以应对交叉污名化和歧视，并提高加纳贫民窟年轻男同性恋者、双性恋者和其他男男性行为者的艾滋病毒检测、暴露前预防（PrEP）及抗逆转录病毒治疗（ART）的接受率：一项整群随机对照试验方案
Status-neutral community-based multilevel intervention to address intersectional stigma and discrimination, and increase HIV testing, PrEP, and ART uptake among YGBMSM in Ghanaian Slums: A clustered randomized control trial protocol.
作者信息
Abu-Ba'are Gamji Rabiu, Torpey Kwasi, Guure Chris, Nelson LaRon E, Jeon Sangchoon, McMahon James, Leblanc Natalie M, Shamrock Osman Wumpini, Zigah Edem Yaw, Apreku Amos, Dakpui Henry Delali, Agbemedu George Rudolph Kofi, Boakye Francis, Adu Prince, Attisoe Andrew, Adjaka Gideon
机构信息
Behavioral, Sexual, and Global Health Lab, School of Nursing, University of Rochester Medical Center, University of Rochester, New York, USA.
Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana.
出版信息
Res Sq. 2024 May 30:rs.3.rs-4486078. doi: 10.21203/rs.3.rs-4486078/v1.
BACKGROUND
While GBMSM constitute less than 2% of Ghana's population, their HIV prevalence surpasses the national average by more than eightfold, emphasizing the critical need for targeted interventions to improve detection, care linkage, and reduce community transmission. This study seeks to increase HIV testing, Pre-Exposure Prophylaxis (PrEP), and Antiretroviral Therapy (ART) uptake (HPART) among YGBMSM through the adaptation of an evidence-based intervention (LAFIYA).
METHODOLOGY
We will employ the ADAPTT-IT framework to adapt LAFIYA and evaluate its feasibility and effectiveness in addressing intersectional stigma and increasing HPART uptake among YGBMSM residing in Ghanaian slums. In aim 1, we will hold focus groups (n=5) and interviews (n=20) among YGBMSM and two FGDs among GBMSM-led organizations. At the HCF level, we will hold 6 FGDs and interviews (n=20) among nurses. In AIM 2, we will randomly assign 6 healthcare facilities (HCFs) to receive the LAFIYA (n=3) or wait-list control (n=3). Friend groups (cluster) of YGBMSM (N=240) will be assigned to receive LAFIYA (n=120) or a wait-list control (n=120). We will collect 3-, 6-, and 9-months post-intervention data among YGBMSM(n=240) and HCWs(n=300) to measure HPART adherence (primary outcomes), ISD reduction, HIV and status-neutral knowledge (secondary outcomes), and intervention acceptability, appropriateness, and feasibility (implementation outcomes).
CONCLUSION
The intervention group will observe increased HPART adherence, reduced ISD, and enhanced HPART knowledge and efficacy relative to the wait-list control group. The findings will inform ISD reduction and HIV status-neutral implementation strategies - and place-based interventions that address access to HIV prevention and care among YGBMSM, slum and in different settings.
TRAIL REGISTRATION
This study was registered on clinicalTrail.gov, with identifier number NCT06312514 on 03/14/2023. https://classic.clinicaltrials.gov/ct2/show/NCT06312514.
背景
尽管男同性恋、双性恋和其他男男性行为者（GBMSM）在加纳人口中所占比例不到2%，但其艾滋病毒感染率超过全国平均水平八倍多，这突出表明迫切需要采取有针对性的干预措施，以改善检测、护理联系并减少社区传播。本研究旨在通过采用循证干预措施（LAFIYA），提高青年男同性恋、双性恋和其他男男性行为者（YGBMSM）中的艾滋病毒检测、暴露前预防（PrEP）和抗逆转录病毒治疗（ART）的接受率（HPART）。
方法
我们将采用ADAPTT-IT框架来调整LAFIYA，并评估其在解决交叉污名化问题以及提高居住在加纳贫民窟的YGBMSM中HPART接受率方面的可行性和有效性。在目标1中，我们将在YGBMSM中开展焦点小组讨论（n = 5）和访谈（n = 20），并在由GBMSM主导的组织中开展两次焦点小组讨论。在卫生保健机构（HCF）层面，我们将在护士中开展6次焦点小组讨论和访谈（n = 20）。在目标2中，我们将随机分配6个卫生保健机构（HCF）接受LAFIYA（n = 3）或进入等待名单对照组（n = 3）。YGBMSM的朋友群体（集群）（N = 240）将被分配接受LAFIYA（n = 120）或等待名单对照组（n = 120）。我们将在干预后3个月、6个月和9个月收集YGBMSM（n = 240）和医护人员（n = 300）的数据，以测量HPART依从性（主要结果）、交叉污名化减少情况、艾滋病毒及无身份歧视知识（次要结果）以及干预措施的可接受性、适宜性和可行性（实施结果）。
结论
与等待名单对照组相比，干预组将观察到HPART依从性增加、交叉污名化减少以及HPART知识和效果增强。研究结果将为减少交叉污名化以及艾滋病毒无身份歧视实施策略提供信息，并为在YGBMSM、贫民窟及不同环境中解决艾滋病毒预防和护理可及性问题的基于地点的干预措施提供信息。
试验注册
本研究已在ClinicalTrials.gov上注册，标识符为NCT06312514，注册日期为2023年3月14日。https://classic.clinicaltrials.gov/ct2/show/NCT06312514 。
Zotero 插件